A 65-year-old woman with Stage IIIA endometrial carcinoma (positive serosal involvement of the uterus and positive adnexa) undergoes optimal cytoreductive surgery with no residual disease. What is the recommended adjuvant treatment?
- A Chemotherapy with carboplatin and paclitaxel ✓
- B External beam pelvic radiotherapy alone
- C Vaginal brachytherapy alone
- D Concurrent chemoradiation followed by adjuvant chemotherapy
Correct answer: A. Chemotherapy with carboplatin and paclitaxel
Explanation
Stage IIIA with adnexal involvement is high-risk extrauterine disease. The GOG-258 trial showed that chemotherapy alone was non-inferior to chemoradiation for stage III endometrial cancer in terms of overall survival, with fewer locoregional recurrences but similar distant control. Current NCCN guidelines recommend chemotherapy with carboplatin and paclitaxel for 6 cycles as primary adjuvant therapy for stage III disease. Radiation may be added for locoregional control in selected cases.
Reference: Williams Gynaecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.